I'm Effaced and Dilated. When will I go into labor?
During the third trimester of pregnancy (after 28 weeks) everything becomes bigger, more uncomfortable, more bloated and the impending birth seems a whole lot nearer.
At this stage it's not uncommon for pains or strange symptoms to make a woman think she's nearing labor - when nothing happens it can be quite a let down.
Doctors often don't help the situation, telling a woman baby is "ready", she's dilated, effaced or baby is head down. But what do these things really mean? How do you interpret what the doctor says into when you're going to go into labor?
The early stages of the following are NOT a sign of labor and can begin to occur 1-15 weeks before labor. They are simply your body's way of preparing for the big event ahead, and do not mean that labor is going to begin soon.
- Dilation - The cervix opens up from 0cm to 10cm in width for birth.
You can open up 1-3cm before labor begins.
- Effacement - The cervix is a long tube. It will efface from 100% in length to 0% for birth.
It's possible to be up to 50% effaced or more before labor begins.
- Braxton Hicks - These are practice contractions and can start as early as 20 weeks gestation.
- Engaging - The baby can "drop" into the birth canal weeks before labor begins, and in some cases even move back up.
You can be dilated or effaced for weeks or months before labour. Or you can be NOT dilated or effaced, with a baby who is not engaged and go into labour and have your baby four hours later.
It's very rare that you NEED an internal examination. Dilation and effacement don't indicate much, and can put more stress on you about when labour will start, or how long it will go for.
Internal examinations have risks and these risks are even higher after your water has broken. It's a good idea to be aware of your rights to refuse an internal exam unless you really feel it's necessary.
What if I had a show, lost my plug or my waters broke?
Mucous Plugs - Can be lost in bits and pieces or as a whole. If lost too early in pregnancy, they can grow back. Not all women lose their mucous plug before labor - some may lose it near the end of labor or may not see it at all.
Bloody Show - Blood that appears when you wipe. This is caused by dilation of capillaries in the cervix as it dilates and often occurs around the same time as the mucous plug is lost. If you have bleeding that is heavy or requires frequent pad changing, you need to see a doctor as soon as possible.
Waters Breaking - Only 10-15% of labors will begin with the amniotic sac breaking. If your sac does break, there is no guarantee that you'll go into labor straight away, although most women will within 24-48 hours.
Effacement - The length of the cervix. The cervix gets shorter till it's completely thinned out for birth.
Dilation - The width of the cervix. The cervix opens up to approximately 10cm to allow the baby's head to birth.
The cervix needs to be fully dilated and effaced before your baby can be born.
Dilation, Effacement And Labor
During the third trimester, it's not uncommon for a doctor to do an internal exam. Often the doctor will report dilation as a percentage or effacement in a centimeter approximation.
It's completely normal for a woman to be both slightly effaced and dilated during the middle to end of the third trimester. It's also normal for her to be not dilated or effaced at all.
Either one will not change the length of the labor or when it will occur. The woman in the first example could have an 18 hour labor at 42 weeks, and the woman in the second example could have a 2 hour labour at 39 weeks and vice versa.
Are These Braxton Hicks Or Labor?
Braxton hicks can often start early in the second trimester. They can range from painless muscle contractions through to painful contraction type pains. So how can you tell if they're real contractions or braxton hicks?
- Real contractions will stay a regular time apart and get closer while braxton hicks will often vary and be irregular.
- Real contractions will continue even if you change positions or activities while braxton hicks usually will not.
- Braxton hicks are sometimes caused by dehdyration - try drinking more water.
In some instances, women may also experience prodromal labor which is the early phase of labor. This is often accompanied by contractions that peak towards a certain time of day and then slow or stop then repeat again the next day.
But My Doctor Said I Could Go Into Labor Any Day
Doctors often tell a pregnant woman that a baby is ready and many women believes this means they will be in labour within a few hours or days.
Unfortunately, a doctor's definition of ready is different to a pregnant woman's. To a doctor, ready simply means your baby is sitting down and in the right position to go into labor. A doctor's timeline is different to yours, so a doctor saying this is the equivalent of saying "Everything is ready but the baby may not choose to come for another 3-6 weeks."
The only way to tell when labor will start is by going into labor. There are no guarantees when it comes to how a pregnant woman's body will react.
Will I Know When I'm In Labor?
Although you may often hear people say "You'll know when you're in labor" this isn't always true.
It's possible to be in early labor for several days without realising it, as early contractions can sometimes be nearly painless.
Some women also confuse labor with braxton hicks. Read the information further up for telling the difference between the two.
However only a tiny percentage of women experience labor so short or so pain free that they can't make it to the hospital. In first births it's even less likely than in second or subsequent ones.
More by this Author
Some natural and effective methods to decrease the length of your labor so you can meet your little one faster!
Wondering if you should try castor oil to induce labor? Find out the facts rather than the rumors on whether it works, how it works, and what to watch out for.
A comprehensive list of ways to induce labor naturally, as well as a guide to when and how you should use the methods listed.